Correlation of nocturnal enuresis with vesicoureteral reflux: a report of 83 cases

Abstract

Objective To explore the relationship between vesicoureteral reflux (VUR) and nocturnal enuresis in children, screen for the risk factors of pediatric VUR and provide rationales for clinical management. Methods This study recruited 83 neurologically normal children and adolescents with a chief complaint of nocturnal enuresis with ultrasonic renal abnormalities, daytime incontinence, urodynamic abnormalities or siblings with a history of VUR. There were 36 boys and 47 girls with an average age of 9.42±3.21 (5-16) years. Voiding cystourethrography (VCUG) was performed for assessing the status of VUR. Also urine routine, urine culture and urological ultrasound scan were performed. Measurement of urinary dynamics, including urinary flow rate, basin electromyography (EMG) and bladder pressure volume, were recorded. Results There were monosymptomatic nocturnal enuresis (MNE) (n=48, 57.8%) and non-monosymptomatic nocturnal enuresis (NMNE) (n=35, 42.2%). And 13 cases (15.7%) had VUR. The incidence was significantly higher for daytime urinary incontinence, girls with VUR and current urinary tract infections (UTI) (P=0.019, 0.006 & 0.017 respectively). Logistic multifactor regression analysis showed that only gender, daytime incontinence and current UTI were statistically significant (P 0.05). Conclusions VUR is common in children with enuresis and daytime incontinence. The relevant examinations are recommended. And UTI is a risk factor for its occurrence. Key words: Enuresis; Vesicoureteral reflux; Regression analysis